Section: Urology Curriculum: Curriculum, page 5
Definition
- Fluid filled sacs located at the head of the epididymis
- Derived from paradidymis (mesonephric tubules blind at both ends)
Epidemiology
- Common (30% of all scrotal USS) in younger patients
Aetiology
- Congenital abnormality
Pathophysiology
- Clear cysts derived from the paradidymis
- Blind ending at both ends
- Different to spermatocoeles that are either only blind ending on one side or >2cm in size, dont contain spermatic fluid
Clinical
- Asymptomatic → painless lump
- Palpable lump separate testes c.f. Hydrocoele
- Can be variable size and multiple, fluctuant and transilluminates
Investigation
- Bloods to R.O infection
- Scrotal USS to confirm cystic nature
Differential Diagnosis
- Cystadenoma
- Cystadenocarcinoma
- Epididymo-orchitis
- Sprematocoele
Management
- Non-operative - confirmed dx and not suspicious or sx
- Operative - excision vs sclerotherapy
- Complications
- Haematoma/bleeding
- Infection/abscess
- Recurrence
- Infertility - if other side is not present or not viable
Prognosis
- Most involute but can surveill with USS